Prima Vista Recovery and Wellness Center LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

PRIMA VISTA RECOVERY AND WELLNESS CENTER LLC

Practice address

7664 S US Highway 1
Port Saint Lucie, FL 34952-2315

Phone

(772) 461-8833

Fax

(772) 461-8872

NPI assigned

Jul 7, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gerald A Dibartolomeo Jr., CPA

Title

Cfo

Phone

(772) 461-8833

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1952784183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7664 S US HIGHWAY 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349522315",
            "telephone_number": "772-461-8833",
            "fax_number": "772-461-8872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7664 S US HIGHWAY 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349522315",
            "telephone_number": "772-461-8833",
            "fax_number": "772-461-8872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMA VISTA RECOVERY AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "DIBARTOLOMEO",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "772-461-8833",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.